Insurance company claims automation with AI

Improving the Claims Process For a Leading Insurance Company Through Automation

Insurance

THE CHALLENGE.

Recently, one of the nation’s leading insurance companies enlisted the team at Pegasus One to help look for ways to improve their current claims process through automation. They were already processing a massive number of claims – they just needed to be able to do so in a faster and more efficient way for everyone involved. Luckily, we had more than a few ideas – many of which embraced the full power of automation with open arms.

Improving the Claims Process For a Leading Insurance Company Through Automation

Insurance

THE CHALLENGE.

Recently, one of the nation’s leading insurance companies enlisted the team at Pegasus One to help look for ways to improve their current claims process through automation. They were already processing a massive number of claims – they just needed to be able to do so in a faster and more efficient way for everyone involved. Luckily, we had more than a few ideas – many of which embraced the full power of automation with open arms.

APPROACH.

Soon after work began, we transcribed more than 15,000 saved calls using voice-to-text technology and got to work analyzing those calls to identify the most commonly repeated activities.

Based on the insight we obtained, we built a chatbot functionality that could then capture those processes automatically. By mapping the revamped first notice of less session to a template of 80 capture fields, we also helped too guarantee that all aspects of a session are captured with maximum accuracy. The session also included recommendations for service representative dialogue, as well.

RESULTS.

Almost immediately, the client enjoyed advantages like:

  • A significant 15% reduction in the average call length due to faster satisfactory resolution times.
  • An essential 43% reduction in call costs due to an improved post-call approval process.
  • An increase in the accuracy of automated transcriptions close to 100%.

VALUE.

After our solution was implemented, all calls were transcribed in real-time. Once a call is completed and that transcription is summarized, it is automatically presented to the service representative’s supervisors for review and approval – thus helping them focus on important factors like quality and efficiency.

The evaluation of the pilot project overwhelmingly showed that call duration and associated costs have gone down. Things were even so successful that the company is expected to launch a full deployment of the AI and analytics tools in the not-too-distant future, and is planning for its next-phase enhancements as well.